Anestesiologia e Pesquisa em Ciências Clínicas


Clinical practice guideline on anaesthesia and perioperative blood transfusion management

Yilkal Tadesse Desta

Hemorrhage may account for a third of in-hospital deaths, particularly in the first 24 h after admission. In massive hemorrhage, mortality exceeds 50%, such figures emphasize that the importance of early recognition of major blood loss and the need for effective action to prevent shock and its consequences. Surgical control to arrest the cause of the hemorrhage is the main intervention, but even when surgery is performed aggressively, hemorrhage portends low survival, more over; Currently, the ideal transfusion ratios or models for transfusion and coagulation management of patients with hemorrhage are unclear or controversial. Additionally, the overall rate of appropriate use of blood was 40.7%; it was inappropriate in 19.2%of cases (hemoglobin>11 g dl±1). Therefore this review will address new information regarding trauma-induced coagulopathy, priorities for intervention, Anesthetics considerations and not to take extra risk comments for management of operative massive bleeding and traumatic patients. To obtain a systematically developed guideline statements that assists in decision?making about appropriate health care and safe use of intra-operative blood transfusion, depending on local circumstances and accessibility at the point of clinical activity. To examine sound and update scientific evidences, which are intended to supplement current resuscitation guidelines and are specifically directed at improving Anaesthetic management of pre-operative anemia, pre-operative hemorrhagic shock and peri-operative acute massive blood loss events. To adapt with discussions and recommendations on why to take extra risk and priorities for treatment, from those revised literatures and professional consensus. To take part in the Hospital Transfusion Committee members and facilitate the development of protocols for the management of safe transfusion and coagulopathies. To take in to account simple template guidelines for acute blood loss which may be modified with local circumstances and displayed in clinical areas.